Chronic Obstructive Pulmonary Disease (COPD) is a chronic slowly progressive disorder characterized by airflow obstruction (reduced FEV1 and FEV1/VC ratio) that does not change markedly over several months. Most of the lung function impairment is fixed, although some reversibility can be produced by bronchodilator (or other) therapy.
For the diagnosis and assessment of COPD, spirometry is the gold standard as it is the most reproducible, standardized, and objective way of measuring airflow limitation. FEV 1 / FVC < 70% and a postbronchodilator FEV 1 < 80% predicted confirms the presence of airflow limitation that is not fully reversible.
1. Consider nasal intermittent positive pressure ventilation if respiratory rate >30 or pH <7.35. I is delivered by nasal mask and a flow generator ↓
2. Consider intubation2 & ventilation if pH<7.26 and PaCO2 is rising
3. Consider respiratory stimulant drug e.g. doxapram 1-2 mg/min IV. SE: agitation, confusion, tachycardia, nausea Only for patients who are not suitable for mechanical ventilation A short – term measure only